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What Content is Included in AF-CBT?
AF-CBT incorporates several behavioral and cognitive-behavioral methods that have been described for and examined with physically abusive or at-risk families by several investigators over the past few decades. The approach draws from several conceptual models, including behavioral and learning theory, cognitive therapy, family-systems therapy, and developmental victimology. AF-CBT targets individual child and parent characteristics related to the abusive experience as well as the larger family context in which coercion or aggression occurs. Thus, this approach can be used to address parent and family risks for/correlates of physical abuse and/or common sequelae exhibited by children following the abuse.
Treatment emphasizes instruction in specific intrapersonal (e.g., cognitive, affective) and interpersonal (e.g., behavioral) skills designed to promote the expression of prosocial behavior and discourage the use of coercive/aggressive behavior at both the individual and family levels. Primary AF-CBT techniques include affect regulation, behavior management, social skills training, cognitive restructuring/problem-solving, and communication. Common treatment goals include reducing a caregiver’s level of anger and use of force, promoting non-aggressive (alternative) discipline strategies, minimizing family risks for re-abuse, enhancing a child’s coping skills, and encouraging non-aggressive family problem-solving and communication.
With its integration of both individual and joint sessions, AF-CBT is suitable for application by trained practitioners in individual, parent-child or family, and group sessions across diverse outpatient, residential, and home settings. The techniques, relevant handouts, training examples, and outcome measures are integrated in a structured approach designed to enhance accessibility to practitioners and supervisors. Although it has been primarily used in outpatient settings, the treatment can be delivered on an individual basis in alternative residential settings, especially if there is some ongoing contact between caregiver and child.